How much rates vary
Facilitymedian $288 · 10th to 90th $170 to $3,981Professionalmedian $234 · 10th to 90th $151 to $363
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $234.42 | Professional | None | $123.03 | $165.96 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $660.69 | Facility | None | $162.18 | $204.17 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $380.19 | Professional | None | $165.96 | $218.78 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $363.08 | Professional | None | $194.98 | $275.42 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $6,606.93 | Facility | None | $234.42 | $331.13 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $316.23 | Professional | None | $151.36 | $223.87 | $316.23 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $281.84 Typical High $295.12 | Facility | None | $169.82 | $281.84 | $295.12 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $245.47 Typical High $707.95 | Facility | None | $169.82 | $245.47 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $239.88 Typical High $380.19 | Professional | None | $79.43 | $239.88 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $6,025.60 | Facility | None | $3,801.89 | $5,248.07 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $331.13 | Professional | None | $213.80 | $281.84 | $331.13 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $389.05 | Professional | None | $173.78 | $251.19 | $389.05 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $83.18 Typical High $114.82 | Professional | 52 · Reduced service | $75.86 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $114.82 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.12 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $114.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $107.15 | $114.82 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $83.18 Typical High $114.82 | Professional | 52 · Reduced service | $81.28 | $83.18 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $33.11 | $33.11 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $123.03 | $123.03 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $34.67 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $23.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $162.18 |
Where Oregon sits
The same service costs 4.0 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 9th of 51
$234
AK $437NJ $110
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.